Phia Group

Having NSA Problems? Better Call The Phia Group

On October 31, 2024
The Independent Dispute Resolution (“IDR”) process was designed to be a cornerstone of the No Surprises Act (“NSA”), a means for resolving claims for payment for out-of-network items and services and a vital mechanism for buttressing the NSA’s protection for plan members against potentially devastating balance billing expenses. Unfortunately, since the NSA took effect on January 1, 2022, things have gone awry on many fronts.

The Future of Birth Control in America

On October 28, 2024
Since the US Supreme Court decided to undo nationwide abortion rights in summer 2022, women’s reproductive rights has arguably been the most pressing topic in healthcare. Naturally, as we enter the final stretch of election season – as well as the Biden administration – the all-important, polarizing matter has resurfaced.

Empowering Plans: P204 – Nightmares on Self-Funded Street

On October 24, 2024
Join Attorneys Corey Crigger and Kendall Jackson on this Halloween edition of the Empowering Plans Podcast. Corey and Kendall take a look at topics that send shivers down the spine of the self-funded industry. How do you protect your plan from the scary cost of gene therapies? What will the rapidly advancing AI sector mean for you and your clients? What is the best trick or treat candy? Tune in to find the answers to these questions and many more on the Empowering Plans Podcast.

Industry Crossroads – How the 2024 Election Impacts You & Major Implications For Our Industry

On October 17, 2024
Although healthcare hasn’t stolen the limelight as it did in past elections, those “in the know” know that the results of this historic election will have a major impact on healthcare and health benefit plans alike. Between soaring drug costs, increased fiduciary litigation, the impact of A/I, and growing popularity of weight-loss drugs (which is likely to escalate as the year ends), to thrive in 2025 and beyond industry insiders must understand the current state of the market as well as predict what is to come. Join us as we discuss these and other pressing issues. Also, speaking of A/I, our team will present a live demonstration of SoPhia, our very own chatbot, which will engage with audience questions.

The Phia Group's 4th Quarter 2024 Newsletter

On October 16, 2024
The Phia Group is off to a great start in the fourth quarter of 2024! Check out our newsletter to get acquainted with some of the latest happenings in our neck of the woods.

Empowering Plans: P203 – Gender-Affirming Care, Is it Covered?

On October 15, 2024
On this episode of the Empowering Plans Podcast, attorneys Jon Jablon and Cindy Merrell explore the changing landscape of several state and federal laws that affect coverage of gender-affirming care.

Cobenfy: A Game-Changer for Schizophrenia Treatment Costs

On October 9, 2024
Cobenfy is a promising new drug for schizophrenia. Find out about its cost, insurance coverage, and how it compares to existing treatment options.

Healthcare and Politics… Ugh. Old News!

On September 27, 2024
Donald Trump recently stated that while he will never give up on repealing the ACA, he also said that he was not running on terminating the ACA. This is likely a smart decision, given that a recent Kaiser Family Foundation (KFF) poll revealed that for Republican voters, repealing Obamacare was an important issue for a very small percent of respondents. Is this demonstrative of a more widespread loss of interest in health care as a political talking point?

Empowering Plans: P202 – Senator Sanders: “Stop ripping us off.”

On September 26, 2024
Attorneys Brady Bizarro and Andrew Silverio discuss the recent senate committee hearing on GLP-1 drug pricing and strategies that self-funded employers are using to manage the extreme costs of these drugs while we wait and hope for congressional action.

The Phia Group Announces the Hiring of Justin Forton as a Client Success Account Executive

On September 19, 2024
CANTON, MA – September 19, 2024 – In its continued dedication to bolstering the health benefits industry, The Phia Group has hired Justin Forton as a Client Success Account Executive. Justin will channel his data analytics experience and industry-focused customer service expertise to support and collaborate with The Phia Group’s clientele.

Medicare's First Ten Negotiated Drug Prices Announced

On September 16, 2024
Discover Medicare's first list of negotiated drug prices, featuring ten high-cost medications. Learn how these changes will impact seniors & healthcare costs.

Empowering Plans: P201 – Diving Into the Parity Pool: MHPAEA’s Latest Updates

On September 12, 2024
Regulators finally announced the long-awaited MHPAEA Final Rules on September 9, 2024. Many of these changes will directly affect group health plan design and modify the NQTL comparative analysis testing requirements - many of which will be significant for plans as they prepare for 2025. Join attorneys Jennifer McCormick and Bryan Dunton for their discussion on several critical considerations for plans as renewal season approaches.

The Phia Group Announces Enhancement to Ecosystem of Services: Care Empowered Pricing

On September 11, 2024
The Phia Group’s industry-leading ecosystem of cost containment services, including ICE, Subrogation & Recovery, PACE, and Phia Unwrapped, has been bolstered with Care Empowered Pricing, a cutting-edge Reference-Based Pricing (RBP) model providing quality care and fair pricing tailored to your needs.

Empowering Plans: P200 – Recognizing Our Blind Spots

On September 5, 2024
Dr. Marty Makary is a New York Times bestselling author, renowned Johns Hopkins surgeon, and globally recognized expert on medical research. In its most recent edition of the Empowering Plans podcast series (“Recognizing Our Blind Spots”), Dr. Makary was a special guest as he engaged in conversation with CEO Adam V. Russo about his new book, Blind Spots: When Medicine Gets It Wrong, and What It Means for Our Health, https://geni.us/blindspots. This is an episode jampacked with enlightening and engaging anecdotes that will leave you with new insight into commonly held assumptions about healthcare. After all, in order to fix the healthcare industry, people need to have access to correct information about modern medicine.

Section 1557 Final Rule | Current Status and Implications

On August 30, 2024
Explore the status of the Section 1557 Final Rule, including its implications for gender identity protections and the challenges posed by recent court rulings.